When did you first learn you had a pelvic floor? There’s a decent chance it wasn’t that long ago — heck, maybe it was today. If you’re still not sure exactly where the pelvic floor is, how it works, or what can go wrong with it, you’ve come to the right place. Origin is pelvic floor central and, as physical therapists, there’s nothing we love more than to clue you into the wonders of your body.
Let's start with a little anatomy: Your pelvic floor is a multi-layered group of multitasking muscles and connective tissues that make up the floor of your pelvis. The muscles run from your pubic bone to your tailbone, and left and right between your two sit bones.
The diagram below will give you the lay of the land. Note how your pelvic muscles overlap each other to form a bowl at the bottom of the pelvis and encircle the vagina, rectum, and urethra. There’s a lot going on in this relatively small space.
Pelvic Floor Functions & Dysfunction
If you’ve ever been to a yoga class or gym, you know how critical your core is. Well, your pelvic floor is the core of your core. These muscles work together with your abdominals, diaphragm, back, and hip muscles to provide stability to your low back and pelvis and facilitate powerful, pain-free movement. Your pelvic floor muscles also lift and support your pelvic organs (bladder, bowel, uterus), and help with blood flow and circulation in this area.
Surrounding your pelvic openings, your muscles squeeze and lift to help keep you continent (aka help prevent bladder and bowel leaks) and they release and open, which is essential when you deliver a baby, have a bowel movement, and enjoy satisfying, pain-free sex.
When these muscles don’t work as they should, it’s called pelvic floor dysfunction (PFD).
Common Signs of Pelvic Floor Dysfunction:
- Bladder or bowel leaks (no matter how small)
- Urinary urgency or frequency
- Pain with vaginal penetration (gyno exams, tampon insertion, sex) or sexual dysfunction
- Difficulty starting the flow of urine or having a bowel movement
- Pelvic heaviness/feeling of your organs falling out (aka pelvic organ prolapse)
- Pelvic pain
- Low back pain
PFD is incredibly common, especially for women and individuals with vaginal anatomy. 40M women annually experience pelvic floor issues, and they can start surprisingly young. Research shows that PDF affects 1 in 10 women in their 20s, and 1 in 3 women over 40. The chances that you’ll have multiple pelvic floor issues goes up with every child that you deliver.
Speaking of childbirth, one of the most critical times to have a pelvic floor physical therapist on your side is before and after delivery. During pregnancy, a PT can help you exercise safely, work and sleep comfortably, learn to push effectively, and prepare your pelvic floor to reduce injuries, including perineal tears. During postpartum, they can help you heal, rebuild strength, and safely return to sex and exercise, when you’re ready.
Physical Therapy & Pelvic Floor Dysfunction
PFD can look different for everyone. Symptoms may be caused by muscle weakness, overactivity, lack of coordination, injury, or a combination of things. The good news is that, if you have dysfunction, a pelvic floor physical therapist can help you restore the balance of strength, flexibility, and coordination that allows your pelvic floor to function at 100%.
Below are some common physical therapy treatments for PFD:
If pelvic floor muscle weakness is the cause of your symptoms, your PT can teach you specific strengthening exercises to improve the power and endurance of those muscles. Pelvic floor contractions, commonly known as Kegels, as well as other core, hip, and back exercises are all an important part of a pelvic floor strengthening program. Your PT will develop an exercise routine specifically tailored to your body and your needs.
Pain & Tension Relief
If you have pelvic pain, it's important to calm your central nervous system, and teach your brain that pain does not have to be the only outcome of movement and/or anal or vaginal touch or penetration. Breathing techniques, yoga stretches, manual therapy, and graded exposure to penetration using biofeedback or vaginal dilators are all tools to help you in your pelvic pain healing journey.
Exercises to Improve Timing & Coordination
Pelvic floor dysfunction can also happen when your brain and pelvic floor muscles and organs have trouble working together. Your PT is trained in specific techniques to improve the coordination of signals between your brain and your body so that your pelvic floor can work as it should. Exercises for timing and coordination are important so that you can use your muscles when you need them the most.
Changes to Everyday Habits
It's common to develop habits in your diet and daily routine to help you cope with pelvic floor symptoms — but these habits can sometimes make your symptoms worse. Your PT will ask you about your routines and habits and help you develop more effective strategies that work for your lifestyle.
What to Expect from Pelvic Floor PT
Getting care for pelvic floor dysfunction can be intimidating, especially if you’re worried that it could be as uncomfortable as a gyno exam. Rest assured that a pelvic floor physical therapy visit at Origin does not involve putting your feet in stirrups! We want every patient to feel safe and comfortable, and your PT will partner with you to determine the type of assessment that’s right for you. In fact, with virtual visits, you can get treatment for most pelvic floor dysfunction without even stepping foot in a clinic.
Your first visit will consist of an evaluation where your physical therapist will ask about your symptoms and medical history, note how you move, and explain how your muscle, tissue, or nerve function may be causing or contributing to your symptoms. They’ll also ask about your schedule, fitness level, energy, and more to determine the type of treatment that will work best for you. Together, you’ll create an evidence-based plan to help you reach your goals.
After your evaluation, you can log into your Origin dashboard, where you’ll find your personalized exercises, resources recommended by your PT, and other tools to support you between visits. Whether your pelvic symptoms have just started or you’ve been dealing with them for years, we’re here to help! Book a visit and start healing now, so you can get back to feeling your best.
Ready to take an even deeper dive? Find out more about your own pelvic floor with this guided self-check.